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Alfotawi R, Premnath S, El-Ghannam A, Alsafadi M, Mahmood A. In Vivo Analysis of Porous Bioactive Silicon Carbide Scaffold for Craniofacial Bone Augmentation. J Craniofac Surg 2023:00001665-990000000-01252. [PMID: 38014939 DOI: 10.1097/scs.0000000000009864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 10/09/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND Bone augmentation is a vital area of research because of its high clinical demand and the reported complications associated with the available biomaterials. Purpose: The study assess the role of decellurized skeletal muscle (DSM) when combined with synthesized porous bioactive silicon carbide (SiC) ceramic and evaluated its ability to augment bone calvaria in a rat model. MATERIAL AND METHODS Eighteen rats were divided into 2 groups; group 1 (n=9), SiC discs (10 × 0.2 mm) pre-treated with 20% NaOH were placed as an onlay grafts on calvarial bone. Meanwhile, in group 2 (n=9), SiC discs pre-treated with 20% NaOH (10 × 0.2 mm) were covered with DSM. After 12 weeks, the grafted tissues were harvested and examined using cone-beam computed tomography, mechanical testing, and histologic analysis. RESULTS Cone-beam computed tomography for group 2 showed more radio-opacity for the remnant of SiC compared with native bone. The surface area and volume of radio-opacity were 2.48 mm2 ± 1.6 and 14.9 ± 7.8 mm3, respectively. The estimated quantitative average surface area of the radio-opacity for group 1 and volume were 2.55 mm2 ± (Sd=3.7) and 11.25 ± (Sd=8.9), respectively. Mechanically, comparable values of the flexural strength and statistically significant higher modulus of elasticity of calvaria in group 1 compared with group 2 and control (P<0.001). Histologically, group 2 region of woven bone was seen close to the lamellar bone (native bone), and there was immature bone present near the implanted SiC. CONCLUSION The tested construct made of SiC/DSM has potential to osteointegrate into native bone, making it a suitable material for bone augmentation.
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Affiliation(s)
- Randa Alfotawi
- Department of Oral and Maxillofacial Surgery, Dental Faculty, King Saud University, Riyadh, Saudi Arabia
| | - Sangeetha Premnath
- Department of Oral and Maxillofacial Surgery, Dental Faculty, King Saud University, Riyadh, Saudi Arabia
| | - Ahmad El-Ghannam
- Department of Mechanical Engineering and Engineering Science, University of North Carolina, Charlotte, NC
| | - Mona Alsafadi
- Stem Cell Unit, Department of Anatomy, College of Medicine, King Saud University, Riyadh, Saudi Arabi
| | - Amer Mahmood
- Stem Cell Unit, Department of Anatomy, College of Medicine, King Saud University, Riyadh, Saudi Arabi
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2
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Guo F, Wang E, Yang Y, Mao Y, Liu C, Bu W, Li P, Zhao L, Jin Q, Liu B, Wang S, You H, Long Y, Zhou N, Guo W. A natural biomineral for enhancing the biomineralization and cell response of 3D printed polylactic acid bone scaffolds. Int J Biol Macromol 2023; 242:124728. [PMID: 37150372 DOI: 10.1016/j.ijbiomac.2023.124728] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 04/27/2023] [Accepted: 04/30/2023] [Indexed: 05/09/2023]
Abstract
Polylactic acid (PLA) has been extensively used as a bone scaffold material, but it still faces many problems including low biomineralization ability, weak cell response, low mechanical properties, etc. In this study, we proposed to utilize the distinctive physical, chemical and biological properties of a natural biomineral with organic matrix, pearl powder, to enhance the overall performance of PLA bone scaffolds. Porous PLA/pearl composite bone scaffolds were prepared using fused deposition modeling (FDM) 3D printing technology, and their comprehensive performance was investigated. Macro- and micro- morphological observation by optical camera and scanning electron microscopy (SEM) showed the 3D printed scaffolds have interconnected and ordered periodic porous structures. Phase analysis by X-ray diffraction (XRD) indicated pearl powder was well composited with PLA without impurity formation during the melt extrusion process. The mechanical test results indicated the tensile and compressive strength of PLA/pearl composite scaffolds with 10 % pearl powder content yielded the highest values, which were 15.5 % and 21.8 % greater than pure PLA, respectively. The water contact angle and water absorption tests indicated that PLA/pearl showed better hydrophilicity than PLA due to the presence of polar groups in the organic matrix of the pearl powder. The results of the simulated body fluid (SBF) soaking revealed that the addition of pearl powder effectively enhanced the formation and deposition of apatite, which was attributed to the release of Ca2+ from the dissolution of pearl powder. The cell culture of bone marrow mesenchymal stem cells (BMSCs) indicated that PLA/pearl scaffolds showed better cell proliferation and osteogenic differentiation than PLA due to the stimulation of the biological organic matrix in pearl powder. These outcomes signify the potential of pearl powder as a natural biomineral containing bio-signal factors to improve the mechanical and biological properties of polymers for better bone tissue engineering application.
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Affiliation(s)
- Feng Guo
- Department of Oral and Maxillofacial Surgery, College of Stomatology, Guangxi Medical University, Nanning 530021, China; Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction, Nanning 530021, China
| | - Enyu Wang
- Guangxi Key Laboratory of Manufacturing System and Advanced Manufacturing Technology, School of Mechanical Engineering, Guangxi University, Nanning 530004, China
| | - Yanjuan Yang
- Guangxi Key Laboratory of Manufacturing System and Advanced Manufacturing Technology, School of Mechanical Engineering, Guangxi University, Nanning 530004, China
| | - Yufeng Mao
- Guangxi Key Laboratory of Manufacturing System and Advanced Manufacturing Technology, School of Mechanical Engineering, Guangxi University, Nanning 530004, China
| | - Chao Liu
- Guangxi Key Laboratory of Manufacturing System and Advanced Manufacturing Technology, School of Mechanical Engineering, Guangxi University, Nanning 530004, China
| | - Wenlang Bu
- Guangxi Key Laboratory of Manufacturing System and Advanced Manufacturing Technology, School of Mechanical Engineering, Guangxi University, Nanning 530004, China
| | - Ping Li
- Guangxi Key Laboratory of Manufacturing System and Advanced Manufacturing Technology, School of Mechanical Engineering, Guangxi University, Nanning 530004, China
| | - Lei Zhao
- Guangxi Key Laboratory of Manufacturing System and Advanced Manufacturing Technology, School of Mechanical Engineering, Guangxi University, Nanning 530004, China
| | - Qingxin Jin
- Guangxi Key Laboratory of Manufacturing System and Advanced Manufacturing Technology, School of Mechanical Engineering, Guangxi University, Nanning 530004, China
| | - Bin Liu
- Department of Bone and Soft Tissue Surgery, Guangxi Medical University Cancer Hospital, Nanning 530021, China
| | - Shan Wang
- Department of Research, Guangxi Medical University Cancer Hospital, Nanning 530021, China
| | - Hui You
- Guangxi Key Laboratory of Manufacturing System and Advanced Manufacturing Technology, School of Mechanical Engineering, Guangxi University, Nanning 530004, China
| | - Yu Long
- Guangxi Key Laboratory of Manufacturing System and Advanced Manufacturing Technology, School of Mechanical Engineering, Guangxi University, Nanning 530004, China; State Key Laboratory of Featured Metal Materials and Life-cycle Safety for Composite Structures, Guangxi University, Nanning 530004, China
| | - Nuo Zhou
- Department of Oral and Maxillofacial Surgery, College of Stomatology, Guangxi Medical University, Nanning 530021, China; Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction, Nanning 530021, China.
| | - Wang Guo
- Guangxi Key Laboratory of Manufacturing System and Advanced Manufacturing Technology, School of Mechanical Engineering, Guangxi University, Nanning 530004, China; State Key Laboratory of Featured Metal Materials and Life-cycle Safety for Composite Structures, Guangxi University, Nanning 530004, China.
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Şahbazoğlu KB, Demirbilek M, Bayarı SH, Buber E, Toklucu S, Türk M, Karabulut E, Akalın FA. In vitro comparison of nanofibrillar and macroporous-spongious composite tissue scaffolds for periodontal tissue engineering. Connect Tissue Res 2022; 63:183-197. [PMID: 33899631 DOI: 10.1080/03008207.2021.1912029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
PURPOSE/AIM OF THE STUDY The ultimate goal of periodontal treatment is to regenerate the lost periodontal tissues. The interest in nanomaterials in dentistry is growing rapidly and has focused on improvements in various biomedical applications, such as periodontal regeneration and periodontal tissue engineering. To enhance periodontal tissue regeneration, hydroxyapatite (HA) was used in conjunction with other scaffold materials, such as Poly lactic-co-glycolic-acid (PLGA) and collagen (C). The main target of this study was to compare the effects of nano and macrostructures of the tissue scaffolds on cell behavior in vitro for periodontal tissue engineering. MATERIALS AND METHODS Nanofibrillar and macroporous-spongious composite tissue scaffolds were produced using PLGA/C/HA. Subgroups with BMP-2 signal molecule and without HA were also created. The scaffolds were characterized by FTIR, SEM/EDX techniques, and mechanical tests. The scaffolds were compared in the periodontal ligament (PDL) and MCT3-E1 cell cultures. The cell behaviors; adhesions by SEM, proliferation by WST-1, differentiation by ALP and mineralization with Alizarin Red Tests were determined. RESULTS Cell adhesion and mineralization were higher in the nanofibrillar scaffolds compared to the macroporous-spongious scaffolds. Macroporous-spongious scaffolds seemed better for the proliferation of PDL cells and differentiation of MC3T3-E1-preosteoblastic cells, while nanofibrillar scaffolds were more convenient for the differentiation of PDL cells and proliferation of MC3T3-E1-preosteoblastic cells. CONCLUSIONS In general, nanofibrillar scaffolds showed more favorable results in cell behaviors, compared to the macroporous-spongious scaffolds, and mostly, BMP-2 and HA promoted the activities of the cells.
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Affiliation(s)
| | - Murat Demirbilek
- Advanced Technologies Application and Research Center, Hacettepe University, Ankara, Turkey.,Biology Department, Ankara Hacı Bayram Veli University, Ankara, Turkey
| | - Sevgi Haman Bayarı
- Department of Physical Engineering, Hacettepe University, Ankara, Turkey
| | - Esra Buber
- Department of Medical Biochemistry, Hacettepe University, Ankara, Turkey
| | - Selçuk Toklucu
- Department of Bioengineering, Kırıkkale University, Kırıkkale, Turkey
| | - Mustafa Türk
- Department of Bioengineering, Kırıkkale University, Kırıkkale, Turkey
| | - Erdem Karabulut
- Department of Biostatistics, Hacettepe University, Ankara, Turkey
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Overexpression Effects of miR-424 and BMP2 on the Osteogenesis of Wharton's Jelly-Derived Stem Cells. BIOMED RESEARCH INTERNATIONAL 2021; 2021:7031492. [PMID: 34790821 PMCID: PMC8592721 DOI: 10.1155/2021/7031492] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 10/06/2021] [Accepted: 10/18/2021] [Indexed: 02/07/2023]
Abstract
Recently, the translational application of noncoding RNAs is accelerated dramatically. In this regard, discovering therapeutic roles of microRNAs by developing synthetic RNA and vector-based RNA is attracting attention. Here, we studied the effect of BMP2 and miR-424 on the osteogenesis of Wharton's jelly-derived stem cells (WJSCs). For this purpose, human BMP2 and miR-424 DNA codes were cloned in the third generation of lentiviral vectors and then used for HEK-293T cell transfection. Lentiviral plasmids contained miR424, BMP-2, miR424-BMP2, green fluorescent protein (GFP) genes, and helper vectors. The recombinant lentiviral particles transduced the WJSCs, and the osteogenesis was evaluated by real-time PCR, Western blot, Alizarin Red staining, and alkaline phosphatase enzyme activity. According to the results, there was a significant increase in the expression of the BMP2 gene and secretion of Osteocalcin protein in the group of miR424-BMP2. Moreover, the amount of dye deposition in Alizarin Red staining and alkaline phosphatase activity was significantly higher in the mentioned group (p < 0.05). Thus, the current study results clarify the efficacy of gene therapy by miR424-BMP2 vectors for bone tissue engineering. These data could help guide the development of gene therapy-based protocols for bone tissue engineering.
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Alfotawi R, Ahmed R, Atteya M, Mahmood A, Siyal A, AlHindi M, El-Ghannam A. Assessment of novel surgical procedures using decellularised muscle and bioactive ceramic: a histological analysis. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2021; 32:113. [PMID: 34453610 PMCID: PMC8403111 DOI: 10.1007/s10856-021-06585-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 06/21/2021] [Indexed: 06/13/2023]
Abstract
Tissue regeneration and neovascularisation in cases of major bone loss is a challenge in maxillofacial surgery. The hypothesis of the present study is that the addition of resorbable bioactive ceramic Silica Calcium Phosphate Cement (SCPC) to Declluraized Muscle Scaffold (DSM) can expedite bone formation and maturation. Two surgical defect models were created in 18 nude transgenic mice. Group 1(n = 6), with a 2-mm decortication calvarial defect, was treated with a DSM/SCPC sheet over the corticated bone as an onlay then seeded with human Mesenchymal Stromal Cells hMSC in situ. In Group 2 (n = 6), a critical size (4 mm) calvarial defect was made and grafted with DSM/SCPC/in situ human bone marrow stromal cells (hMSCs). The control groups included Group 3 (n = 3) animals, with a 2-mm decortication defect treated with an onlay DSM sheet, and Group 4 (n = 3) animals, treated with critical size defect grafted with plain DSM. After 8 weeks, bone regeneration in various groups was evaluated using histology, immunohistochemistry and histomorphometry. New bone formation and maturation was superior in groups treated with DSM/SCPC/hMSC. The DMS/SCPC scaffold has the ability to augment and induce bone regeneration and neovascularisation in cases of major bone resorption and critical size defects.
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Affiliation(s)
- Randa Alfotawi
- Oral & Maxillofacial dept, Dental Collage, King Saud University, Riyadh, Saudi Arabia.
| | - Raeesa Ahmed
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Muhammad Atteya
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Amer Mahmood
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | | | - Marium AlHindi
- Oral & Maxillofacial dept, Dental Collage, King Saud University, Riyadh, Saudi Arabia
| | - Ahmad El-Ghannam
- Department of Mechanical Engineering and Engineering Science, University of North Carolina, Chapel Hill, NC, USA
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Alshihri S, Kindi M, Alfotawi R, Hindi MA, Alghamdi O, Ramalingam S, Assiri M. Assessment of Bone Regeneration Using Tooth Ash and Injectable Platelet Rich Fibrin: A Microcomputed Tomographic (CT) Analysis. J BIOMATER TISS ENG 2021. [DOI: 10.1166/jbt.2021.2659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Introduction: One of the main challenge of bone graft or socket preservation in particular is to get good quality and quantity of bone in short time prior to implant bed preparation. The buccal bone at the crest of the ridge is a very thin bone and usually resorb faster than
the rest of alveolar bone which may hinder an optimum dento-osseous implant insertion. The purpose of this study will be to assess the bone regeneration capabilities of Tooth Ash Particles (TAP) with injectable Plasma Rich Fibrin (i-PRF) and Tooth Ash Particles (TAP) alone at defects created
in the goat mandible bone using micro-computed tomographic (micro-CT). Materials and Methods: A total, 54 bone defect (5 mm × 8 mm) were performed in the 18 goats. The created defect received different treatment (Tx): Tx.A: Unfilled defect (allow natural bone regeneration; Tx.B:
Tooth Ash particle (TAP) alone; Tx.C: Tooth Ash + injectable PRF (TAP/i-PRF). Six goats, were sacrificed at different time points:Group 1: at 2nd week, Group2: at 5th week and Group3 at 8th week. The newly formed bone (NFB) was analyzed using micro-CT at different time points. Quantitative
and qualitative assessment were carried out namely; the volume of new bone formation (NF-BV) within the defect and its mineral density (NF-BMD), Trabecular Thickness (Tb Th), Trabecular Number (Tb N) and Trabecular Separation (Tb Sp). Result: By 8th week, the mean NF-BV was 69.482 ±
6.554 mm3 (cubic millimeter), 65.872±6.804 mm3, 26.820±14.643 mm3, while the mean NF-BMD was 0.417±0.119g/mm3, 0.786±0.036 g/mm3, 0.805±0.033 g/mm3 for the defects which received Tx.C, Tx.B
and Tx.A respectively. At 8th weekTb Th of NFB was 0.612±0.168, 0.913±0.112, and 0.701 ±0.126, Trabecular Number of NFB was 2.062±0.946, 1.002±0.155, and 1.816±2.042 and, Trabecular Separation of NFB was 0.330 ±0.131, 0.559 ±0.110, and
0.495 ±0.258 for the defects which received Tx.A, Tx.B and Tx.C respectively. Conclusion: Micro-CT study demonstrated that tooth ash particles mixed with injectable Platelet Rich Fibrin (i-PRF) on mandibular bone defect in goat’s model, resulting in new bone with significantly
higher volume, mineral density and less remodeling rate when compared with normal bone regeneration of unfilled defects.
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Affiliation(s)
- Saleh Alshihri
- Oral and Maxillofacial Resident, Faculty of Dentistry, King Saud University, Riyadh, 11545, KSA
| | - Mohammed Kindi
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, King Saud University, Riyadh, 11545, KSA
| | - Randa Alfotawi
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, King Saud University, Riyadh, 11545, KSA
| | - Marium Al Hindi
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, King Saud University, Riyadh, 11545, KSA
| | - Osama Alghamdi
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, King Saud University, Riyadh, 11545, KSA
| | - Sundar Ramalingam
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, King Saud University, Riyadh, 11545, KSA
| | - Mohammed Assiri
- Department of Oral and Maxillofacial Surgery, Dental Faculty, Najran University, Najran, 1988, KSA
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Schorn L, Fienitz T, De Donno F, Sterner-Kock A, Maul AC, Holtmann H, Lommen J, Rothamel D. Critical-size Defect Augmentation Using Sintered and Non-Sintered Bovine Bone Matrix - An Experimental Controlled Study in Minipigs. J Oral Maxillofac Surg 2021; 79:1866-1873. [PMID: 34051155 DOI: 10.1016/j.joms.2021.03.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 03/11/2021] [Accepted: 03/23/2021] [Indexed: 01/14/2023]
Abstract
PURPOSE Xenogeneic bone substitute materials are often used for augmentation of larger bone defects. Purification methods for these materials vary, mainly in terms of temperature. The aim of this study was to determine in vivo how sintering affects quantitative and qualitative bone regeneration of 2 bovine augmentation materials. METHODS A total of 56 critical size defects were set at the frontal bone of 14 domestic pigs (4 each) and filled randomly with either bovine, sintered hydroxyapatite (BO), bovine, non-sintered hydroxyapatite (BOS), local autologous bone (AB) or left empty. All defects were additionally covered with a collagen membrane. Specimens were harvested after 4 and 8 weeks and were evaluated histologically and histomorphometrically. RESULTS Histologically new bone could be seen in every group. Significantly highest new bone formation was found in AB. No significant difference could be detected between BO and BOS. CONCLUSIONS According to the results of this study, sintered bone substitute material remains histologically distinguishable but does not affect quantitative and qualitative bone regeneration.
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Affiliation(s)
- Lara Schorn
- Resident, Department of Oral, Maxillofacial and Facial Plastic Surgery, University Hospital Düsseldorf Düsseldorf, DE
| | - Tim Fienitz
- Resident, Department of Oral, Maxillofacial and Facial Plastic Surgery, Evangelisches Krankenhaus Bethesda, Mönchengladbach, DE; Head of Department, Department of Oral, Maxillofacial and Facial Plastic Surgery, Evangelisches Krankenhaus Bethesda, Mönchengladbach, Germany and Professor, , University Hospital Düsseldorf, Düsseldorf,DE.
| | - Francesco De Donno
- Resident, Department of Oral, Maxillofacial and Facial Plastic Surgery, Evangelisches Krankenhaus Bethesda, Mönchengladbach, DE
| | - Anja Sterner-Kock
- Professor, Head of Department, Center for Experimental Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, DE
| | - Alexandra C Maul
- Head of Department, Center for Experimental Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, DE
| | - Henrik Holtmann
- Consultant, Department of Oral, Maxillofacial and Facial Plastic Surgery, Evangelisches Krankenhaus Bethesda, Mönchengladbach,DE
| | - Julian Lommen
- Resident, Department of Oral, Maxillofacial and Facial Plastic Surgery, University Hospital Düsseldorf Düsseldorf,DE
| | - Daniel Rothamel
- Head of Department, Department of Oral, Maxillofacial and Facial Plastic Surgery, Evangelisches Krankenhaus Bethesda, Mönchengladbach, Germany and Professor, , University Hospital Düsseldorf, Düsseldorf,DE
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El-Ghannam A, Nakamura M, Muguruza LB, Sarwar U, Hassan M, Fotawi RA, Horowitz R. Inhibition of osteoclast activities by SCPC bioceramic promotes osteoblast-mediated graft resorption and osteogenic differentiation. J Biomed Mater Res A 2021; 109:1714-1725. [PMID: 33733590 DOI: 10.1002/jbm.a.37167] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 03/07/2021] [Accepted: 03/09/2021] [Indexed: 01/25/2023]
Abstract
Maximizing vital bone in a grafted site is dependent on a number of factors. These include resorption or turnover of the graft material, stimulation of bone formation pathway without a need for biological molecules added to the site and inhibition of cellular activities that compromise the mineralization of new bone matrix. In the present study, the dissolution profile of silica-calcium phosphate composite (SCPC) in physiological solution was measured and the data were fed to (ANN-NARX) prediction model to predict the time required for complete dissolution. The inductively coupled plasma-optical emission spectrometer ionic composition analysis of the culture medium incubated for 3 days with SCPC showed 57% decrease in Ca concentration and a significant increase in the concentration of Si (13.5 ± 1.8 μg/ml), P (249.4 ± 22 μg/ml), and Na (9.3 ± 0.52 μg/ml). In conjunction with the release of Si, P, and Na ions, the bone resorptive activity of osteoclasts was inhibited as indicated by the significant decrease in multinucleated tartrate resistant acidic phosphate stained cells and the volume of resorption pits on bone slices. In contrast, addition of SCPC to hBMSC cultured in conventional medium promoted higher Runt-related transcription factor 2 (p < .05), osteocalcin (p < .01), and bone sialo protein (p < .01) than that expressed by control cells grown in the absence of SCPC. The predicted dissolution time of 200 mg of porous SCPC particles in 10 ml phosphate buffered saline is 6.9 months. An important byproduct of the dissolution is inhibition of osteoclastic activity and promotion of osteoblastic differentiation and hence bone formation.
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Affiliation(s)
- Ahmed El-Ghannam
- Department of Mechanical Engineering and Engineering Science, University of North Carolina at Charlotte, Charlotte, North Carolina, USA
| | - Miho Nakamura
- Medicity Research Laboratory, Faculty of Medicine, University of Turku, Turku, Finland
| | | | - Uruj Sarwar
- Medicity Research Laboratory, Faculty of Medicine, University of Turku, Turku, Finland
| | - Mohammad Hassan
- Department of Mechanical Engineering and Engineering Science, University of North Carolina at Charlotte, Charlotte, North Carolina, USA.,Faculty of Engineering, Mechanical Engineering Department, Helwan University, Cairo, Egypt
| | - Randa Al Fotawi
- Oral and Maxillofacial Surgery Department, School of Dental medicine, King Abdulazeez University, Riyadh, Saudi Arabia
| | - Robert Horowitz
- Periodontology and Implant Dentistry, The NYU College of Dentistry, New York, New York, USA
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Schorn L, Fienitz T, Gerstenberg MF, Sterner-Kock A, Maul AC, Lommen J, Holtmann H, Rothamel D. Influence of different carrier materials on biphasic calcium phosphate induced bone regeneration. Clin Oral Investig 2021; 25:3729-3737. [PMID: 33433653 DOI: 10.1007/s00784-020-03700-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 11/23/2020] [Indexed: 12/18/2022]
Abstract
OBJECTIVES Biphasic calcium phosphate (BCP) is a bioceramic material successfully used in alloplastic bone augmentation. Despite many advantages, a disadvantage of BCP seems to be a difficult application and position instability. The aim of this study was to determine how different carrier materials influence BCP-induced quantitative and qualitative bone regeneration. MATERIALS AND METHODS A total of 70 critical size defects were set in the frontal bone of 14 domestic pigs (5 each) and filled randomly with either BCP alone (BCP), BCP in combination with nano-hydroxyapatite (BCP + NHA), BCP embedded in native porcine type I/III collagen blocks (BCP + C), autologous bone (AB), or were left empty (ED). Specimens were harvested after 4 and 8 weeks and were evaluated histologically as well as histomorphometrically. RESULTS Significantly lowest rate of new bone formation was found in ED (p = < 0.001) and BCP + NHA groups (p = 0.05). After 8 weeks, the highest percentage of new bone formation was observed in the BCP + C group. Fibrous matrix was detected highest in BCP alone. The lowest residual bone substitute material was found in BCP + C after 8 weeks. CONCLUSIONS BCP-induced bone regeneration is indeed affected by different carrier types. Surface morphology and bioactive characteristics influence osseointegration and new bone formation in vivo. The combination of type I/III collagen seems most suitable for qualitative and quantitative bone regeneration. CLINICAL RELEVANCE Stabilization of granular bone substitutes using type I/III collagen might be an alternative to granulates alone, indicating excellent volume stability, satisfactory plasticity, and easy application.
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Affiliation(s)
- Lara Schorn
- Department of Oral-, Maxillofacial and Facial Plastic Surgery, University Hospital Düsseldorf, Moorenstr. 5, Düsseldorf, Germany
| | - Tim Fienitz
- Department of Oral-, Maxillofacial and Facial Plastic Surgery, Evangelisches Krankenhaus Bethesda, Ludwig-Weber-Straße 15, 41061, Mönchengladbach, Germany.
| | - Maximilian F Gerstenberg
- Department of Oral-, Maxillofacial and Facial Plastic Surgery, University Hospital of Cologne, Kerpener Str. 64, 50937, Cologne, Germany
| | - Anja Sterner-Kock
- Center for Experimental Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Str. 64, 50937, Cologne, Germany
| | - Alexandra C Maul
- Center for Experimental Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Str. 64, 50937, Cologne, Germany
| | - Julian Lommen
- Department of Oral-, Maxillofacial and Facial Plastic Surgery, University Hospital Düsseldorf, Moorenstr. 5, Düsseldorf, Germany
| | - Henrik Holtmann
- Department of Oral-, Maxillofacial and Facial Plastic Surgery, Evangelisches Krankenhaus Bethesda, Ludwig-Weber-Straße 15, 41061, Mönchengladbach, Germany
| | - Daniel Rothamel
- Department of Oral-, Maxillofacial and Facial Plastic Surgery, University Hospital Düsseldorf, Moorenstr. 5, Düsseldorf, Germany.,Department of Oral-, Maxillofacial and Facial Plastic Surgery, Evangelisches Krankenhaus Bethesda, Ludwig-Weber-Straße 15, 41061, Mönchengladbach, Germany
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10
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Baranova J, Büchner D, Götz W, Schulze M, Tobiasch E. Tooth Formation: Are the Hardest Tissues of Human Body Hard to Regenerate? Int J Mol Sci 2020; 21:E4031. [PMID: 32512908 PMCID: PMC7312198 DOI: 10.3390/ijms21114031] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 06/02/2020] [Accepted: 06/03/2020] [Indexed: 12/12/2022] Open
Abstract
With increasing life expectancy, demands for dental tissue and whole-tooth regeneration are becoming more significant. Despite great progress in medicine, including regenerative therapies, the complex structure of dental tissues introduces several challenges to the field of regenerative dentistry. Interdisciplinary efforts from cellular biologists, material scientists, and clinical odontologists are being made to establish strategies and find the solutions for dental tissue regeneration and/or whole-tooth regeneration. In recent years, many significant discoveries were done regarding signaling pathways and factors shaping calcified tissue genesis, including those of tooth. Novel biocompatible scaffolds and polymer-based drug release systems are under development and may soon result in clinically applicable biomaterials with the potential to modulate signaling cascades involved in dental tissue genesis and regeneration. Approaches for whole-tooth regeneration utilizing adult stem cells, induced pluripotent stem cells, or tooth germ cells transplantation are emerging as promising alternatives to overcome existing in vitro tissue generation hurdles. In this interdisciplinary review, most recent advances in cellular signaling guiding dental tissue genesis, novel functionalized scaffolds and drug release material, various odontogenic cell sources, and methods for tooth regeneration are discussed thus providing a multi-faceted, up-to-date, and illustrative overview on the tooth regeneration matter, alongside hints for future directions in the challenging field of regenerative dentistry.
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Affiliation(s)
- Juliana Baranova
- Department of Biochemistry, Institute of Chemistry, University of São Paulo, Avenida Professor Lineu Prestes 748, Vila Universitária, São Paulo 05508-000, Brazil;
| | - Dominik Büchner
- Department of Natural Sciences, Bonn-Rhein-Sieg University of Applied Sciences, von-Liebig-Straße 20, 53359 Rheinbach, NRW, Germany; (D.B.); (M.S.)
| | - Werner Götz
- Oral Biology Laboratory, Department of Orthodontics, Dental Hospital of the University of Bonn, Welschnonnenstraße 17, 53111 Bonn, NRW, Germany;
| | - Margit Schulze
- Department of Natural Sciences, Bonn-Rhein-Sieg University of Applied Sciences, von-Liebig-Straße 20, 53359 Rheinbach, NRW, Germany; (D.B.); (M.S.)
| | - Edda Tobiasch
- Department of Natural Sciences, Bonn-Rhein-Sieg University of Applied Sciences, von-Liebig-Straße 20, 53359 Rheinbach, NRW, Germany; (D.B.); (M.S.)
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Huang D, Ren J, Li R, Guan C, Feng Z, Bao B, Wang W, Zhou C. Tooth Regeneration: Insights from Tooth Development and Spatial-Temporal Control of Bioactive Drug Release. Stem Cell Rev Rep 2020; 16:41-55. [PMID: 31834583 PMCID: PMC6987083 DOI: 10.1007/s12015-019-09940-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Tooth defect and tooth loss are common clinical diseases in stomatology. Compared with the traditional oral restoration treatment, tooth regeneration has unique advantages and is currently the focus of oral biomedical research. It is known that dozens of cytokines/growth factors and other bioactive factors are expressed in a spatial-temporal pattern during tooth development. On the other hand, the technology for spatial-temporal control of drug release has been intensively studied and well developed recently, making control release of these bioactive factors mimicking spatial-temporal pattern more feasible than ever for the purpose of tooth regeneration. This article reviews the research progress on the tooth development and discusses the future of tooth regeneration in the context of spatial-temporal release of developmental factors.
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Affiliation(s)
- Delan Huang
- Guanghua School of Stomatology, Hospital of Stomatology, and Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Jianhan Ren
- Guanghua School of Stomatology, Hospital of Stomatology, and Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Runze Li
- Guanghua School of Stomatology, Hospital of Stomatology, and Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Chenyu Guan
- Guanghua School of Stomatology, Hospital of Stomatology, and Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Zhicai Feng
- Guanghua School of Stomatology, Hospital of Stomatology, and Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Baicheng Bao
- Guanghua School of Stomatology, Hospital of Stomatology, and Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Weicai Wang
- Guanghua School of Stomatology, Hospital of Stomatology, and Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Chen Zhou
- Guanghua School of Stomatology, Hospital of Stomatology, and Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China
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Schorn L, Handschel J, Lommen J, VON Beck FP, Depprich R, Kübler N, Holtmann H. Evaluation of Biocompatibility of Different Membrane Surfaces Using Unrestricted Somatic Stem Cells. In Vivo 2020; 33:1447-1454. [PMID: 31471391 DOI: 10.21873/invivo.11623] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 07/10/2019] [Accepted: 07/19/2019] [Indexed: 01/31/2023]
Abstract
BACKGROUND/AIM Results of Guided Bone Regeneration (GBR) primarily depend on the membrane used. The aim of this study was to compare biocompatibility of different absorbable and non-absorbable membranes by using unrestricted somatic stem cells (USSCs) as an indicator for biocompatibility. MATERIALS AND METHODS Five absorbable membranes (Bio-Gide®, RESODONT®, GENTA-FOIL resorb®, BioMend® and BioMend® Extend™) and one non-absorbable alternative (GORE-TEX®) were colonized with USSCs. After 24 h, 3 days and 7 days, cell proliferation, cell viability, and cytotoxicity were assessed. Moreover, cell morphology was evaluated by electron microscopy. RESULTS Significantly higher cell proliferation and cell viability rates were observed in Bio-Gide® and RESODONT® membranes. Cell toxicity was highest on GENTA-FOIL resorb® membranes. The electron microscopical assessment showed a better cell attachment on porous surfaced membranes. CONCLUSION This study shows that USSCs can be used for assessments of biocompatibility, and that absorbable membranes with collagenous composition and porous structure tend to positively impact biocompatibility and enhance cell proliferation.
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Affiliation(s)
- Lara Schorn
- Department of Oral-, Maxillo- and Plastic Facial Surgery, Heinrich-Heine-University and University Hospital Duesseldorf, Duesseldorf, Germany
| | - Jörg Handschel
- Klinik und Praxisgemeinschaft am Kaiserteich, Düsseldorf, Germany
| | - Julian Lommen
- Department of Oral-, Maxillo- and Plastic Facial Surgery, Heinrich-Heine-University and University Hospital Duesseldorf, Duesseldorf, Germany
| | - Felix Paulssen VON Beck
- Department of Oral-, Maxillo- and Plastic Facial Surgery, Malteser Krankenhaus, St. Josefshospital Uerdingen, Krefeld-Uerdingen, Germany
| | - Rita Depprich
- Department of Oral-, Maxillo- and Plastic Facial Surgery, Heinrich-Heine-University and University Hospital Duesseldorf, Duesseldorf, Germany
| | - Norbert Kübler
- Department of Oral-, Maxillo- and Plastic Facial Surgery, Heinrich-Heine-University and University Hospital Duesseldorf, Duesseldorf, Germany
| | - Henrik Holtmann
- Department of Oral-, Maxillo- and Plastic Facial Surgery, Malteser Krankenhaus St. Johannes-Stift, Duisburg, Germany
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Adel-Khattab D, Afifi NS, Abu El Sadat SM, Aboul-Fotouh MN, Tarek K, Horowitz RA. Bone regeneration and graft material resorption in extraction sockets grafted with bioactive silica-calcium phosphate composite (SCPC) versus non-grafted sockets: clinical, radiographic, and histological findings. J Periodontal Implant Sci 2020; 50:418-434. [PMID: 33350181 PMCID: PMC7758298 DOI: 10.5051/jpis.2000040002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 04/21/2020] [Accepted: 06/05/2020] [Indexed: 11/19/2022] Open
Abstract
Purpose The purpose of the present study was to evaluate the effect of silica-calcium phosphate composite (SCPC) granules on bone regeneration in extraction sockets. Methods Ten patients were selected for a split-model study. In each patient, bone healing in SCPC-grafted and control ungrafted sockets was analyzed through clinical, radiographic, histomorphometric, and immunohistochemical assessments 6 months postoperatively. Results A radiographic assessment using cone-beam computed tomography showed minimal ridge dimension changes in SCPC-grafted sockets, with 0.39 mm and 1.79 mm decreases in height and width, respectively. Core bone biopsy samples were obtained 6 months post-extraction during implant placement and analyzed. The average percent areas occupied by mature bone, woven bone, and remnant particles in the SCPC-grafted sockets were 41.3%±12%, 20.1%±9.5%, and 5.3%±4.4%, respectively. The percent areas of mature bone and woven bone formed in the control ungrafted sockets at the same time point were 31%±14% and 24.1%±9.4%, respectively. Histochemical and immunohistochemical analyses showed dense mineralized bundles of type I collagen with high osteopontin expression intensity in the grafted sockets. The newly formed bone was well vascularized, with numerous active osteoblasts, Haversian systems, and osteocytes indicating maturation. In contrast, the new bone in the control ungrafted sockets was immature, rich in type III collagen, and had a low osteocyte density. Conclusions The resorption of SCPC granules in 6 months was coordinated with better new bone formation than was observed in untreated sockets. SCPC is a resorbable bone graft material that enhances bone formation and maturation through its stimulatory effect on bone cell function. Trial Registration ClinicalTrials.gov Identifier: NCT03897010
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Affiliation(s)
- Doaa Adel-Khattab
- Department of Oral Medicine, Periodontology and Diagnosis, Ain Shams University Faculty of Dentistry, Cairo, Egypt
| | - Nermeen S Afifi
- Department of Oral Pathology, Ain Shams University Faculty of Dentistry, Cairo, Egypt.,Department of Oral Pathology, Misr International University Faculty of Dentistry, Cairo, Egypt
| | | | - Mona N Aboul-Fotouh
- Master of Periodontology and Implantology, Ain Shams University Faculty of Dentistry, Cairo, Egypt
| | - Karim Tarek
- Master of Oral Surgery, Ain Shams University Faculty of Dentistry, Cairo, Egypt
| | - Robert A Horowitz
- Departments of Oral Surgery, Periodontology and Implant Dentistry, The NYU College of Dentistry, New York, NY, USA.
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Abstract
Soft and hard tissue engineering has expanded the frontiers of oral/maxillofacial augmentation. Soft tissue grafting enhancements include improving flap prevascularization and using stem cells and other cells to create not only the graft, but also the vascularization and soft tissue scaffolding for the graft. Hard tissue grafts have been enhanced by osteoinductive factors, such as bone morphogenic proteins, that have allowed the elimination of harvesting autogenous bone and thus decrease the need for other surgical sites. Advancements in bone graft scaffolds have developed via seeding with stem cells and improvement of the silica/calcium/phosphate composite to improve graft characteristics and healing.
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Affiliation(s)
- Dolphus R Dawson
- Division of Periodontology, Department of Oral Health Practice, College of Dentistry, University of Kentucky, 800 Rose Street, D-444 Dental Sciences Building, Lexington, KY 40536-0297, USA.
| | - Ahmed El-Ghannam
- Department of Mechanical Engineering and Engineering Science, University of North Carolina at Charlotte, 9201 University City Boulevard, Charlotte, NC 28223-0001, USA
| | - Joseph E Van Sickels
- Division of Oral and Maxillofacial Surgery, College of Dentistry, University of Kentucky, 800 Rose Street, Lexington, KY 40536-0297, USA
| | - Noel Ye Naung
- Division of Oral and Maxillofacial Surgery, College of Dentistry, University of Kentucky, 800 Rose Street, Lexington, KY 40536-0297, USA
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15
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Donos N, Dereka X, Calciolari E. The use of bioactive factors to enhance bone regeneration: A narrative review. J Clin Periodontol 2019; 46 Suppl 21:124-161. [DOI: 10.1111/jcpe.13048] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 11/08/2018] [Accepted: 12/20/2018] [Indexed: 12/17/2022]
Affiliation(s)
- Nikos Donos
- Centre for Oral Immunobiology & Regenerative Medicine & Centre for Oral Clinical Research (COCR); Institute of Dentistry, Barts & The London School of Medicine & Dentistry; Queen Mary University of London (QMUL); London UK
| | - Xanthippi Dereka
- Centre for Oral Immunobiology & Regenerative Medicine & Centre for Oral Clinical Research (COCR); Institute of Dentistry, Barts & The London School of Medicine & Dentistry; Queen Mary University of London (QMUL); London UK
- Department of Periodontology; School of Dentistry; National and Kapodistrian University of Athens; Athens Greece
| | - Elena Calciolari
- Centre for Oral Immunobiology & Regenerative Medicine & Centre for Oral Clinical Research (COCR); Institute of Dentistry, Barts & The London School of Medicine & Dentistry; Queen Mary University of London (QMUL); London UK
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Alici-Garipcan A, Korkusuz P, Bilgic E, Askin K, Aydin HM, Ozturk E, Inci I, Ozkizilcik A, Kamile Ozturk K, Piskin E, Vargel I. Critical-size alveolar defect treatment via TGF-ß3 and BMP-2 releasing hybrid constructs. JOURNAL OF BIOMATERIALS SCIENCE-POLYMER EDITION 2019; 30:415-436. [DOI: 10.1080/09205063.2019.1571397] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- Aybuke Alici-Garipcan
- Department of Chemical Engineering and Bioengineering Division, Hacettepe University, Ankara, Turkey
| | - Petek Korkusuz
- Faculty of Medicine Department of Histology and Embryology, Hacettepe University, Ankara, Turkey
| | - Elif Bilgic
- Faculty of Medicine Department of Histology and Embryology, Hacettepe University, Ankara, Turkey
| | - Kerem Askin
- Faculty of Dentistry Department of Endodontics, Hacettepe University, Ankara, Turkey
| | - Halil M. Aydin
- Faculty of Engineering Environmental Engineering Department & Bioengineering Division, Hacettepe University, Ankara, Turkey
| | - Eda Ozturk
- Faculty of Medicine Department of Biostatistics, Hacettepe University, Ankara, Turkey
| | - Ilyas Inci
- Department of Chemical Engineering and Bioengineering Division, Hacettepe University, Ankara, Turkey
| | - Asya Ozkizilcik
- Department of Chemical Engineering and Bioengineering Division, Hacettepe University, Ankara, Turkey
| | | | - Erhan Piskin
- Department of Chemical Engineering and Bioengineering Division, Hacettepe University Ankara, Ankara, Turkey
| | - Ibrahim Vargel
- Faculty of Medicine Department of Plastic Reconstructive and Aesthetic Surgery & Bioengineering Division, Hacettepe University, Ankara, Turkey
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Sudheesh Kumar P, Hashimi S, Saifzadeh S, Ivanovski S, Vaquette C. Additively manufactured biphasic construct loaded with BMP-2 for vertical bone regeneration: A pilot study in rabbit. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2018; 92:554-564. [DOI: 10.1016/j.msec.2018.06.071] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 05/29/2018] [Accepted: 06/30/2018] [Indexed: 12/18/2022]
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Carlisle P, Guda T, Silliman DT, Burdette AJ, Talley AD, Alvarez R, Tucker D, Hale RG, Guelcher SA, BrownBaer PR. Localized low-dose rhBMP-2 is effective at promoting bone regeneration in mandibular segmental defects. J Biomed Mater Res B Appl Biomater 2018; 107:1491-1503. [PMID: 30265782 DOI: 10.1002/jbm.b.34241] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2018] [Revised: 08/11/2018] [Accepted: 08/18/2018] [Indexed: 12/29/2022]
Abstract
At least 26% of recent battlefield injuries are to the craniomaxillofacial (CMF) region. Recombinant human bone morphogenetic protein 2 (rhBMP-2) is used to treat CMF open fractures, but several complications have been associated with its use. This study tested the efficacy and safety of a lower (30% recommended) dose of rhBMP-2 to treat mandibular fractures. rhBMP-2 delivered via a polyurethane (PUR) and hydroxyapatite/β-tricalcium phosphate (Mastergraft®) scaffold was evaluated in a 2 cm segmental mandibular defect in minipigs. Bone regeneration was analyzed at 4, 8, and 12 weeks postsurgery using clinical computed tomography (CT) and rhBMP-2, and inflammatory marker concentrations were analyzed in serum and surgery-site drain effluent. CT scans revealed that pigs treated with PUR-Mastergraft® + rhBMP-2 had complete bone bridging, while the negative control group showed incomplete bone-bridging (n = 6). Volumetric analysis of regenerated bone showed that the PUR-Mastergraft® + rhBMP-2 treatment generated significantly more bone than control by 4 weeks, a trend that continued through 12 weeks. Variations in inflammatory analytes were detected in drain effluent samples and saliva but not in serum, suggesting a localized healing response. Importantly, the rhBMP-2 group did not exhibit an excessive increase in inflammatory analytes compared to control. Treatment with low-dose rhBMP-2 increases bone regeneration capacity in pigs with mandibular continuity defects and restores bone quality. Negative complications from rhBMP-2, such as excessive inflammatory analyte levels, were not observed. Together, these results suggest that treatment with low-dose rhBMP-2 is efficacious and may improve safety when treating CMF open fractures. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 107B: 1491-1503, 2019.
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Affiliation(s)
- Patricia Carlisle
- Department of Craniomaxillofacial Regenerative Medicine, Dental and Trauma Research Detachment, Fort Sam Houston, Texas, 78234
| | - Teja Guda
- Department of Biomedical Engineering, University of Texas at San Antonio, San Antonio, Texas, 78249
| | - David T Silliman
- Department of Craniomaxillofacial Regenerative Medicine, Dental and Trauma Research Detachment, Fort Sam Houston, Texas, 78234
| | - Alexander J Burdette
- United States Naval Medical Research Unit-San Antonio, Fort Sam Houston, Texas, 78234
| | - Anne D Talley
- Department of Chemical and Biomolecular Engineering, Vanderbilt University, Nashville, TN, 37235
| | - Rene Alvarez
- United States Naval Medical Research Unit-San Antonio, Fort Sam Houston, Texas, 78234
| | - David Tucker
- Department of Craniomaxillofacial Regenerative Medicine, Dental and Trauma Research Detachment, Fort Sam Houston, Texas, 78234
| | - Robert G Hale
- Department of Craniomaxillofacial Regenerative Medicine, Dental and Trauma Research Detachment, Fort Sam Houston, Texas, 78234
| | - Scott A Guelcher
- Department of Chemical and Biomolecular Engineering, Vanderbilt University, Nashville, TN, 37235
| | - Pamela R BrownBaer
- Department of Craniomaxillofacial Regenerative Medicine, Dental and Trauma Research Detachment, Fort Sam Houston, Texas, 78234
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Off-Label Use of Bone Morphogenetic Protein 2 in the Reconstructions of Mandibular Continuity Defects. J Craniofac Surg 2017; 28:227-230. [PMID: 27977485 DOI: 10.1097/scs.0000000000003291] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
This paper describes 3 patients of off-label use of bone morphogenetic protein 2 (rhBMP-2) in the reconstruction of mandibular continuity defects. In the first patient, rhBMP-2 was associated with iliac crest bone graft for late mandibular reconstruction after resection of osteosarcoma. In the 2 other patients, rhBMP-2 was used alone. In 1 patient the mandibular continuity defect was due to resection for treatment of osteomyelitis and in the other patient a continuity defect was created by unsuccessful osteogenic distraction for correction of mandibular hypoplasia. Despite the good results in those patients, the off-label use of rhBMP-2 is associated with increased rate of complications, so more studies are needed to assess the predictability of the use of rhBMP-2 in mandibular continuity defects. Therefore, at the moment the off-label use of rhBMP-2 should be restricted to complicated bone defects in which the conventional alternatives of reconstruction were unsuccessful.
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Schorn L, Sproll C, Ommerborn M, Naujoks C, Kübler NR, Depprich R. Vertical bone regeneration using rhBMP-2 and VEGF. Head Face Med 2017; 13:11. [PMID: 28592312 PMCID: PMC5463342 DOI: 10.1186/s13005-017-0146-0] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Accepted: 05/29/2017] [Indexed: 11/25/2022] Open
Abstract
Background Sufficient vertical and lateral bone supply and a competent osteogenic healing process are prerequisities for the successful osseointegration of dental implants in the alveolar bone. Several techniques including autologous bone grafts and guided bone regeneration are applied to improve quality and quantity of bone at the implantation site. Depending on the amount of lacking bone one- or two-stage procedures are required. Vertical bone augmentation has proven to be a challenge particularly in terms of bone volume stability. This study focuses on the three dimensional vertical bone generation in a one stage procedure in vivo. Therefore, a collagenous disc-shaped scaffold (ICBM = Insoluble Collagenous Bone Matrix) containing rhBMP-2 (Bone Morphogenetic Protein-2) and/or VEGF (Vascular Endothelial Growth Factor) was applied around the coronal part of a dental implant during insertion. RhBMP-2 and VEGF released directly at the implantation site were assumed to induce the generation of new vertical bone around the implant. Methods One hundred eight titanium implants were inserted into the mandible and the tibia of 12 mini pigs. Four experimental groups were formed: Control group, ICBM, ICBM + BMP-2, and ICBM + BMP-2 + VEGF. After 1, 4 and 12 weeks the animals were sacrificed and bone generation was investigated histologically and histomorphometrically. Results After 12 weeks the combination of ICBM + rhBMP2 + VEGF showed significantly more bone volume density (BVD%), a higher vertical bone gain (VBG) and more vertical bone gain around the implant (PVBG) in comparison to the control group. Conclusion By using collagenous disc-shaped matrices in combination with rhBMP-2 and VEGF vertical bone can be generated in a one stage procedure without donor site morbidity. The results of the presenting study suggest that the combination of rhBMP-2 and VEGF applied locally by using a collagenous carrier improves vertical bone generation in vivo. Further research is needed to establish whether this technique is applicable in clinical routines.
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Affiliation(s)
- Lara Schorn
- Department of Oral-, Maxillo- and Plastic Facial Surgery, Heinrich-Heine-University Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany
| | - Christoph Sproll
- Department of Oral-, Maxillo- and Plastic Facial Surgery, Heinrich-Heine-University Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany.
| | - Michelle Ommerborn
- Department of Operative and Preventive Dentistry and Endodontics, Heinrich-Heine-University Duesseldorf, Moorenstr. 5, Duesseldorf, 40225, Germany
| | - Christian Naujoks
- Department of Oral-, Maxillo- and Plastic Facial Surgery, Heinrich-Heine-University Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany
| | - Norbert R Kübler
- Department of Oral-, Maxillo- and Plastic Facial Surgery, Heinrich-Heine-University Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany
| | - Rita Depprich
- Department of Oral-, Maxillo- and Plastic Facial Surgery, Heinrich-Heine-University Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany
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Patel N, Kim B, Zaid W, Spagnoli D. Tissue Engineering for Vertical Ridge Reconstruction. Oral Maxillofac Surg Clin North Am 2016; 29:27-49. [PMID: 27890226 DOI: 10.1016/j.coms.2016.08.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
This article provides an overview of basic tissue engineering principles as they are applied to vertical ridge defects and reconstructive techniques for these types of deficiencies. Presented are multiple clinical cases ranging from office-based dentoalveolar procedures to the more complex reconstruction of postresection mandibular defects. Several different types of regenerative tissue constructs are presented; either used alone or in combination with traditional reconstructive techniques and procedures, such as maxillary sinus augmentation, Le Fort I osteotomy, and microvascular free tissue transfer. The goal is to also familiarize the reconstructive surgeon to potential future strategies in vertical alveolar ridge augmentation.
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Affiliation(s)
- Neel Patel
- Department of Oral and Maxillofacial Surgery, Louisiana State University Health Sciences Center, 1100 Florida Ave, Box 220, Room 5303, New Orleans, LA 70119, USA.
| | - Beomjune Kim
- Department of Oral and Maxillofacial Surgery, Louisiana State University Health Sciences Center, 1100 Florida Avenue, Box 220, Room 5303, New Orleans, LA, USA
| | - Waleed Zaid
- Department of Oral and Maxillofacial Surgery, Louisiana State University Health Sciences Center, 1100 Florida Avenue, Box 220, Room 5303, New Orleans, LA, USA
| | - Daniel Spagnoli
- Private Practice, Brunswick Oral and Maxillofacial Surgery, 621-B North Fodale Avenue, Southport, NC 28461, USA
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